Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Biomedical Engineering / Biomedizinische Technik

Joint Journal of the German Society for Biomedical Engineering in VDE and the Austrian and Swiss Societies for Biomedical Engineering and the German Society of Biomaterials

Editor-in-Chief: Dössel, Olaf

Editorial Board: Augat, Peter / Habibović, Pamela / Haueisen, Jens / Jahnen-Dechent, Wilhelm / Jockenhoevel, Stefan / Knaup-Gregori, Petra / Lenarz, Thomas / Leonhardt, Steffen / Plank, Gernot / Radermacher, Klaus M. / Schkommodau, Erik / Stieglitz, Thomas / Boenick, Ulrich / Jaramaz, Branislav / Kraft, Marc / Lenthe, Harry / Lo, Benny / Mainardi, Luca / Micera, Silvestro / Penzel, Thomas / Robitzki, Andrea A. / Schaeffter, Tobias / Snedeker, Jess G. / Sörnmo, Leif / Sugano, Nobuhiko / Werner, Jürgen /

6 Issues per year


IMPACT FACTOR 2017: 1.096
5-year IMPACT FACTOR: 1.492

CiteScore 2017: 0.48

SCImago Journal Rank (SJR) 2017: 0.202
Source Normalized Impact per Paper (SNIP) 2017: 0.356

Online
ISSN
1862-278X
See all formats and pricing
More options …
Volume 63, Issue 5

Issues

Volume 57 (2012)

A compact hyperspectral camera for measurement of perfusion parameters in medicine

Axel Kulcke / Amadeus Holmer / Philip Wahl / Frank Siemers
  • Department of Plastic and Hand Surgery and Burn Unit, BG Klinikum Bergmannstrost, Merseburger Strasse 165, 06002 Halle (Saale), Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Thomas Wild
  • Department of Plastic, Aesthetic and Hand Surgery, Interdisciplinary Center for Treatment of Chronic Wounds, Auenweg 38, 06847 Dessau, Germany
  • Department of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodore Fontane, Auenweg 38, 06847 Dessau, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Georg Daeschlein
  • Department of Dermatology, University Medicine Greifswald, Sauerbruchstr., 17475 Greifswald, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2018-03-09 | DOI: https://doi.org/10.1515/bmt-2017-0145

Abstract

Worldwide, chronic wounds are still a major and increasing problem area in medicine with protracted suffering of patients and enormous costs. Beside conventional wound treatment, for instance kinds of oxygen therapy and cold plasma technology have been tested, providing an improvement in the perfusion of wounds and their healing potential, but these methods are unfortunately not sufficiently validated and accepted for clinical practice to date. Using hyperspectral imaging technology in the visible (VIS) and near infrared (NIR) region with high spectral and spatial resolution, perfusion parameters of tissue and wounds can be determined. We present a new compact hyperspectral camera which can be used in clinical practice. From hyperspectral data the hemoglobin oxygenation (StO2), the relative concentration of hemoglobin [tissue hemoglobin index (THI)] and the so-called NIR-perfusion index can be determined. The first two parameters are calculated from the VIS-part of the spectrum and represent the perfusion of superficial tissue layers, whereas the NIR-perfusion index is calculated from the NIR-part representing the perfusion in deeper layers. First clinical measurements of transplanted flaps and chronic ulcer wounds show, that the perfusion level can be determined quantitatively allowing sensitive evaluation and monitoring for an optimization of the wound treatment planning and for validation of new treatment methods.

Keywords: free flap monitoring; hyperspectral imaging; perfusion imaging; tissue oxygenation; wound diagnostics

References

  • [1]

    Fluhr JW, Jünger M. The price for treatment of chronic skin diseases: different approaches. Dermatology 2007;214:6–7.Google Scholar

  • [2]

    Posnett J, Gottrup F, Lundgren H, Saal G. The resource impact of wounds on health-care providers in Europe. J Wound Care 2009;18:154–61.Google Scholar

  • [3]

    Doerler M, Reich-Schupke S, Altmeyer P, Stücker M. Impact on wound healing and efficacy of various leg ulcer debridement techniques. J Dtsch Dermatol Ges 2012;10:624–32.Google Scholar

  • [4]

    Klein S, Schreml S, Dolderer J, Gehmert S, Niederbichler A, Landthaler M, et al. Evidence-based topical management of chronic wounds according to the T.I.M.E. principle. J Dtsch Dermatol Ges 2013;11:819–29.Google Scholar

  • [5]

    Dissemond J, Augustin M, Eming SA, Goerge T, Horn T, Karrer S, et al. Modern wound care – practical aspects of non-interventional topical treatment of patients with chronic wounds. J Dtsch Dermatol Ges 2014;12:541–54.Google Scholar

  • [6]

    Arsenault KA, McDonald J, Devereaux PJ, Thorlund K, Tittley JG, Whitlock RP. The use of transcutaneous oximetry to predict complications of chronic wound healing: a systematic review and meta-analysis. Wound Repair Regen 2011;19:657–63.Google Scholar

  • [7]

    Sowa MG, Kuo WC, Ko AC, Armstrong DG. Review of near infrared methods for wound assessment. J Biomed Opt 2016;21:091304.Google Scholar

  • [8]

    Furuta T, Sone M, Fujimoto Y, Yagi S, Sugiura M, Kamei Y, et al. Free flap blood flow evaluated using two-dimensional laser speckle flowgraphy. Int J Otolaryngol 2011;2011:297251.Google Scholar

  • [9]

    Blot SI, Monstrey SJ. The use of laser Doppler imaging in measuring wound-healing progress. Arch Surg 2001;136:116.Google Scholar

  • [10]

    Daly SM, Leahy MJ. ‘Go with the flow’: a review of methods and advancements in blood flow imaging. J Biophotonics 2013;6:217–55.Google Scholar

  • [11]

    Alander JT, Kaartinen I, Laakso A, Pätilä T, Spillmann T, Tuchin VV, et al. A review of indocyanine green fluorescent imaging in surgery. Int J Biomed Imaging 2012;2012:940585.Google Scholar

  • [12]

    Eisenbeiß W, Marotz J, Schrade JP. Reflection-optical multispectral imaging method for objective determination of burn depth. Burns 1999;25:697–707.Google Scholar

  • [13]

    Basiri A, Nabili M, Mathews S, Libin A, Groah S, Noordmans HJ, et al. Use of a multi-spectral camera in the characterization of skin wounds. Opt Express 2010;18:3244–57.Google Scholar

  • [14]

    Lu G, Fei B. Medical hyperspectral imaging: a review. J Biomed Opt 2014;19:1–23.Google Scholar

  • [15]

    Randeberg LL, Hegstad JL, Paluchowski L, Milanič M, Pukstad BS. Hyperspectral characterization of an in vitro wound model. Proc SPIE 8926, Photonic Therapeutics and Diagnostics 2014;X:892607.

  • [16]

    Schmidt WD, Liebold K, Fassler D, Wollina U. Contact-free spectroscopy of leg ulcers: principle, technique, and calculation of spectroscopic wound scores. J Invest Dermatol 2001;116:531–5.Google Scholar

  • [17]

    Liebold K, Fassler D, Schmidt WD, Kühn T, Wollina U. In vivo spectroscopy in dermatology – methods and new fields of application. J Eur Acad Dermatol Venereol 2000;14:1–4.Google Scholar

  • [18]

    Schmidt J, Hapfelmeier A, Schmidt WD, Wollina U. Improving wound score classification with limited remission spectra. Int Wound J 2012;9:189–98.Google Scholar

  • [19]

    Chin JA, Wang EC, Kibbe MR. Evaluation of hyperspectral technology for assessing the presence and severity of peripheral artery disease. J Vasc Surg 2011;54:1679–88.Google Scholar

  • [20]

    Yudovsky D, Nouvong A, Schomacker K, Pilon L. Hyperspectral imaging in diabetic foot wound care. J Diab Sci Technol 2010;4:1099–113.Google Scholar

  • [21]

    Nouvong A, Hoogwerf B, Mohler E, Davis B, Tajaddini A, Medenilla E. Evaluation of diabetic foot ulcer healing with hyperspectral imaging of oxyhemoglobin and desoxyhemoglobin. Diabetes Care 2009;32:2056–61.Google Scholar

  • [22]

    Yudovsky D, Nouvong A, Schomacker K, Pilon L. Monitoring temporal development and healing of diabetic foot ulceration using hyperspectral imaging. J Biophotonics 2011;4:565–76.Google Scholar

  • [23]

    Khaodhiar L, Dinh T, Schomacker KT, Panasyuk SV, Freeman JE, Lew R, et al. The use of medical hyperspectral technology to evaluate microcirculatory changes in diabetic foot ulcers and to predict clinical outcomes. Diabetes Care 2007;30:903–10.Google Scholar

  • [24]

    Chin MS, Freniere BB, Lo YC, Saleeby JH, Baker SP, Strom HM, et al. Hyperspectral imaging for early detection of oxygenation and perfusion changes in irradiated skin. J Biomed Opt 2012;17:1–5.Google Scholar

  • [25]

    Zuzak KJ, Schaeberle MD, Lewis EN, Levin IW. Visible reflectance hyperspectral imaging: characterization of a noninvasive, in vivo system for determining tissue perfusion. Anal Chem 2002;7:2021–8.Google Scholar

  • [26]

    Marotz J, Siafliakis A, Holmer A, Kulcke A, Siemers F. First results of a new hyperspectral camera system for chemical based wound analysis. Wound Medicine 2015;10–11:17–22.Google Scholar

  • [27]

    Holmer A, Tetschke, F, Marotz J, Malberg H, Markgraf W, Thiele C, et al. Oxygenation and perfusion monitoring with a hyperspectral camera system for chemical based tissue analysis of skin and organs. Physiol Meas 2016;37:2064–78.Google Scholar

  • [28]

    Holmer A, Marotz J, Wahl P, Dau M, Kämmerer PW. Hyperspectral imaging in perfusion and wound diagnostics – methods and algorithms for the determination of tissue parameters. Biomed Eng-Biomed Tech 2018;63:547–56.Google Scholar

  • [29]

    Stratonnikov AA, Loschenov VB. Evaluation of blood oxygen saturation in vivo from diffuse reflectance spectra. J Biomed Optics 2001;6:457–67.Google Scholar

  • [30]

    Fox PM, Zeidler K, Carey J, Lee GK. White light spectroscopy for free flaps monitoring. Microsurgery 2013;33:198–202.Google Scholar

  • [31]

    Smit JM, Zeebregts CJ, Acosta R, Werker PM. Advancements in free flap monitoring in the last decade: a critical review. Plast Reconstr Surg 2020;125:177–85.Google Scholar

  • [32]

    Perng CK. Recent advances in postoperative free microvascular flap monitoring. Formos J Surg 2013;46:145–8.Google Scholar

  • [33]

    Meier JK, Prantl L, Müller S, Moralis A, Liebsch G, Gosau M. Simple, fast and reliable perfusion monitoring of microvascular flaps. Clin Hemorheol Microcirc 2012;50:13–24.Google Scholar

  • [34]

    Emmert S, Brehmer F, Hänßle H, Helmke A, Mertens N, Ahmed R, et al. Atmospheric pressure plasma in dermatology. Ulcus treatment and much more. Clin Plasma Med 2013;1:24–9.Google Scholar

  • [35]

    Tiede R, Hirschberg J, Däschlein G, von Woedtke T, Viöl W, Emmert S. Plasma applications: a dermatology review. Contrib Plasma Phys 2014;54:118–30.Google Scholar

  • [36]

    Von Woedtke T, Metelmann HR, Weltmann KD. Clinical plasma medicine: state and perspectives of in vivo application of cold atmospheric plasma. Contrib Plasm Phys 2014;54:104–17.Google Scholar

About the article

Received: 2017-08-18

Accepted: 2017-12-04

Published Online: 2018-03-09

Published in Print: 2018-10-25


Author Statement

Research funding: Authors state no funding involved.

Conflict of interest: The hyperspectral camera prototype described in this publication was developed by Diaspective Vision GmbH. The first, second and third author are employees of this company. In the long term, Diaspective Vision has proprietary interest in the development of the camera system resulting in a product for routine clinical use. The clinical tests of the camera have been performed by clinicians (authors 4, 5 and 6). We certify that the clinical investigators and co-authors have no financial interests and financial arrangements with Diaspective Vision and have received no funding for the measurements and/or preparation of this manuscript. The cameras used during the measurements have been provided by Diaspective Vision.

Informed consent: All patients have signed an informed consent.

Ethical approval: Experimental hyperspectral measurements from patients for the evaluation of the new technology for perfusion measurements and wound description have obtained the ethics approval by the Ethics committee of the Ärztekammer Sachsen-Anhalt, Germany (35/17) and the Ethics Committee of the University of Greifswald (EUDAMED-No. CIV-17-02-018504). The study was conducted according to the Declaration of Helsinki.


Citation Information: Biomedical Engineering / Biomedizinische Technik, Volume 63, Issue 5, Pages 519–527, ISSN (Online) 1862-278X, ISSN (Print) 0013-5585, DOI: https://doi.org/10.1515/bmt-2017-0145.

Export Citation

©2018 Walter de Gruyter GmbH, Berlin/Boston.Get Permission

Comments (0)

Please log in or register to comment.
Log in